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nurs 216 > pain/inflammation > Flashcards

pain/inflammation Flashcards

1
Q

afferent pathway

A

sensory information from PNS to CNS
- afferent

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2
Q

nociceptors

A

located in skin, bones, blood vessels, visceral organs

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3
Q

pain pathway

A

stimulus –> nociceptors –> 1st order neuron (A or C fibres) –> dorsal root and ganglion –> substance P –> 2nd order neuron- decussates–> white mater –> thalamus –> 3rd order neuron –> somatosensory cortex–> effect

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4
Q

endogenous opioid peptides

A

inhibitory neurotransmitters
- endorphins
- released from hypothalamus and limbic system
- descending pathway
- inhibit substance

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5
Q

reduction of pain sensation

A

secretion of serotonin and norepinephrine

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6
Q

pain treatment

A

stops pain signal transmission

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7
Q

non-opioid centrally acting agents

A

stop pain signal transmission at CNS level
- acetaminophen, opioids

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8
Q

NSAID’s

A

stop pain signal transmission at peripheral level

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9
Q

pain rated 4/10

A

give non-opioid medications
- NSAID, tylenol

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10
Q

pain rated 4-6/10

A

give opioids
- codeine, morphine

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11
Q

pain rated greater than 6/10

A

higher potency opioids

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12
Q

acetaminophen

A

centrally acting analgesic
- PO, antipyretic, high efficacy

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13
Q

opioids

A

centrally acting analgesics
- agonist for mu, kappa, and delta receptors
- inhibits substance P release

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14
Q

fentanyl, hydromorphone, meperidine, morphine, methadone

A

high efficacy opioids

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15
Q

hydrocodone, oxycodone, oxycontin, tramadol

A

moderate efficacy opioids

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16
Q

percocet, percodan, vicodin, tramacet

A

combo opioids

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17
Q

codeine

A

combo opioid, unreliable bioavailability

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18
Q

analgesia receptor side effects

A

sedation, nightmares

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19
Q

dopamine receptor side effects

A

euphoria, psychological dependence

20
Q

histamine receptor side effects

A

pruritus, decreased GI, urinary retention

21
Q

naloxone (narcan)

A

treatment of opioid overdose
- quick onset of action, lasts 45 min

22
Q

anti-inflammatory drugs

A

stop prostaglandin synthesis through COX inhibition

23
Q

inflammation

A

synthesis of prostaglandins from arachidonic acid to produce inflammatory process

24
Q

COX 1

A

present in all tissues
- protects gastric mucosa, supports platelet aggregation
- undesirable inhibition

25
Q

COX 2

A

present at sites of tissue injury
- mediates inflammation, mediates fever
- desirable inhibition

26
Q

celecoxib

A

selective COX 2 anti-inflammatory
- cardiovascular related complications
- black box warning

27
Q

ASA (aspirin), Ibuprofen, diclofenac, naproxen, ketorolac

A

non selective COX inhibitors

28
Q

glucocorticoids

A

“one”; steroidal, endogenous, lipophilic, nuclear receptor binding, secreted from adrenal cortex
- potent, high efficacy

29
Q

glucocorticoid effects

A

stimulates gluconeogenesis, low muscle, high blood glucose, COX 2 inhibition, suppression of histamine release

30
Q

hydrocortisone, prednisone, dexamethasone

A

glucocorticoids
- lipophilic, highly PPB

31
Q

dexamethasone

A

used for systemic inflammation
- autoimmune, anaphylaxis, joints

32
Q

budenoside, fluticasone, mometasone

A

used for allergic rhinitis

33
Q

pulmicort, Qvar, flovent

A

used for asthma

34
Q

asthma prevention medications

A

glucocorticoids, leukotriene modifiers, mast cell stabilizers

35
Q

asthma rescue medications

A

bronchodilators, anticholinergics, epinephrine

36
Q

anticholinergics

A

inhibits PNS; atrovent
- bronchodilator, anti ACH

37
Q

atrovent

A

anticholinergic

38
Q

histamine

A

primary mediator of sensory stimulated inflammation
- stored in mast cells and released when cell comes in contact with allergen

39
Q

histamine location

A

smooth muscle of vascular system, digestive tract, bronchial tree, CNS

40
Q

antihistamines (H1 antagonists)

A

“ine”; antagonizes H1 receptors

41
Q

first gen antihistamines

A

crosses BBB, CNS side effects

42
Q

diphenhydramine (benadryl), chlorpheniramine (benylin)

A

first gen antihistamines

43
Q

second gen antihistamines

A

decreased CNS distribution

44
Q

claritin (loratadine), reactin (cetirizine)

A

second gen antihistamines

45
Q

antitussives

A

cough treatment
- CNS depression of cough reflex
- codeine

46
Q

adrenergic agonists

A

“edrine”; treat congestion
- SNS stimulation causing decreased nasal secretions
- ephedrine, pseudoephedrine

47
Q

ephedrine

A

adrenergic agonist

nurs 216 (8 decks)

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